Prediction of the course of antibiotic-associated diarrhea caused by <i>Clostridioides difficile</i> based on clinical and laboratory characteristics of the disease
Background. The most severe complications of antibiotic use are clostridial infection (CDI) and pseudomembranous colitis (PMC). There is a need for further study of these conditions and identification of their triggers. Aim. To identify risk factors for severe forms of antibiotic-associated diarr...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | Russian |
| Published: |
"Consilium Medicum" Publishing house
2024-12-01
|
| Series: | Терапевтический архив |
| Subjects: | |
| Online Access: | https://ter-arkhiv.ru/0040-3660/article/viewFile/637236/pdf |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850058345035071488 |
|---|---|
| author | Konstantin D. Ermolenko Tatiana V. Potapova Kseniia V. Silav Konstantin V. Zhdanov Dmitry A. Lioznov Denis A. Gusev |
| author_facet | Konstantin D. Ermolenko Tatiana V. Potapova Kseniia V. Silav Konstantin V. Zhdanov Dmitry A. Lioznov Denis A. Gusev |
| author_sort | Konstantin D. Ermolenko |
| collection | DOAJ |
| description | Background. The most severe complications of antibiotic use are clostridial infection (CDI) and pseudomembranous colitis (PMC). There is a need for further study of these conditions and identification of their triggers.
Aim. To identify risk factors for severe forms of antibiotic-associated diarrhea caused by Clostridioides difficile.
Materials and methods. A clinical and laboratory examination of 440 patients with CDI who were treated at Botkin Clinical Infectious Diseases Hospital was conducted. CDI was confirmed by detection of toxins A and B of C. difficile in feces using enzyme-linked immunosorbent assay and immunochromatography. Metronidazole (2 g/day, in patients without comorbid pathology) and vancomycin (0.5–2 g/day) were used as a starting drug for up to 14 days. Statistical processing of the obtained data was performed using the Statistica for Windows, v.10 (StatSoft, USA) program.
Results. CDI was confirmed by enzyme-linked immunosorbent assay in 202 (45.91%) patients, immunochromatography – in 149 (33.86%), endoscopically – in 203 (46.14%). CDI was most frequently recorded in 2 age groups of patients: 18–30 years old – in 137 (31.14%); over 60 years old – in 205 (46.59%). CDI was characterized by a combination of colitic and intoxication syndromes. In 43 (9.77%) patients the disease resulted in death. The diagnosis of PMС was established in 61 (13.86%) people. The risks of developing PMC when prescribing antibacterial drugs decreased in the following order: fluoroquinolones, cephalosporins, macrolides, penicillins, nitrofurans and chloramphenicol. Probiotic drugs reduced the risk of developing PMC (relative risk 0.5 [0.3; 0.7]; p=0.002).
Conclusion. PMC was characterized by a combination of diarrhea, intoxication and abdominal pain. The formation of PMC was preceded by courses of antibacterial drugs of the fluoroquinolone and cephalosporin groups, eradication therapy for Helicobacter infection, the use of high doses of glucocorticosteroids, as well as intestinal superinfection in patients with previous episodes of CDI. |
| format | Article |
| id | doaj-art-8179cfa90b864bec84359057a7088fa1 |
| institution | DOAJ |
| issn | 0040-3660 2309-5342 |
| language | Russian |
| publishDate | 2024-12-01 |
| publisher | "Consilium Medicum" Publishing house |
| record_format | Article |
| series | Терапевтический архив |
| spelling | doaj-art-8179cfa90b864bec84359057a7088fa12025-08-20T02:51:11Zrus"Consilium Medicum" Publishing houseТерапевтический архив0040-36602309-53422024-12-0196111042104810.26442/00403660.2024.11.20304078617Prediction of the course of antibiotic-associated diarrhea caused by <i>Clostridioides difficile</i> based on clinical and laboratory characteristics of the diseaseKonstantin D. Ermolenko0https://orcid.org/0000-0002-1730-8576Tatiana V. Potapova1https://orcid.org/0009-0008-8604-9345Kseniia V. Silav2https://orcid.org/0009-0008-0264-9504Konstantin V. Zhdanov3https://orcid.org/0000-0002-3679-1874Dmitry A. Lioznov4https://orcid.org/0000-0003-3643-7354Denis A. Gusev5https://orcid.org/0000-0001-9202-3231Pediatric Research and Clinical Center for Infectious DiseasesPavlov First Saint Petersburg State Medical UniversityPediatric Research and Clinical Center for Infectious DiseasesPediatric Research and Clinical Center for Infectious DiseasesPavlov First Saint Petersburg State Medical UniversityBotkin Clinical Infectious Diseases HospitalBackground. The most severe complications of antibiotic use are clostridial infection (CDI) and pseudomembranous colitis (PMC). There is a need for further study of these conditions and identification of their triggers. Aim. To identify risk factors for severe forms of antibiotic-associated diarrhea caused by Clostridioides difficile. Materials and methods. A clinical and laboratory examination of 440 patients with CDI who were treated at Botkin Clinical Infectious Diseases Hospital was conducted. CDI was confirmed by detection of toxins A and B of C. difficile in feces using enzyme-linked immunosorbent assay and immunochromatography. Metronidazole (2 g/day, in patients without comorbid pathology) and vancomycin (0.5–2 g/day) were used as a starting drug for up to 14 days. Statistical processing of the obtained data was performed using the Statistica for Windows, v.10 (StatSoft, USA) program. Results. CDI was confirmed by enzyme-linked immunosorbent assay in 202 (45.91%) patients, immunochromatography – in 149 (33.86%), endoscopically – in 203 (46.14%). CDI was most frequently recorded in 2 age groups of patients: 18–30 years old – in 137 (31.14%); over 60 years old – in 205 (46.59%). CDI was characterized by a combination of colitic and intoxication syndromes. In 43 (9.77%) patients the disease resulted in death. The diagnosis of PMС was established in 61 (13.86%) people. The risks of developing PMC when prescribing antibacterial drugs decreased in the following order: fluoroquinolones, cephalosporins, macrolides, penicillins, nitrofurans and chloramphenicol. Probiotic drugs reduced the risk of developing PMC (relative risk 0.5 [0.3; 0.7]; p=0.002). Conclusion. PMC was characterized by a combination of diarrhea, intoxication and abdominal pain. The formation of PMC was preceded by courses of antibacterial drugs of the fluoroquinolone and cephalosporin groups, eradication therapy for Helicobacter infection, the use of high doses of glucocorticosteroids, as well as intestinal superinfection in patients with previous episodes of CDI.https://ter-arkhiv.ru/0040-3660/article/viewFile/637236/pdfpseudomembranous colitisantibioticsclostridial infectionprobioticsantibiotic-associated diarrhea |
| spellingShingle | Konstantin D. Ermolenko Tatiana V. Potapova Kseniia V. Silav Konstantin V. Zhdanov Dmitry A. Lioznov Denis A. Gusev Prediction of the course of antibiotic-associated diarrhea caused by <i>Clostridioides difficile</i> based on clinical and laboratory characteristics of the disease Терапевтический архив pseudomembranous colitis antibiotics clostridial infection probiotics antibiotic-associated diarrhea |
| title | Prediction of the course of antibiotic-associated diarrhea caused by <i>Clostridioides difficile</i> based on clinical and laboratory characteristics of the disease |
| title_full | Prediction of the course of antibiotic-associated diarrhea caused by <i>Clostridioides difficile</i> based on clinical and laboratory characteristics of the disease |
| title_fullStr | Prediction of the course of antibiotic-associated diarrhea caused by <i>Clostridioides difficile</i> based on clinical and laboratory characteristics of the disease |
| title_full_unstemmed | Prediction of the course of antibiotic-associated diarrhea caused by <i>Clostridioides difficile</i> based on clinical and laboratory characteristics of the disease |
| title_short | Prediction of the course of antibiotic-associated diarrhea caused by <i>Clostridioides difficile</i> based on clinical and laboratory characteristics of the disease |
| title_sort | prediction of the course of antibiotic associated diarrhea caused by i clostridioides difficile i based on clinical and laboratory characteristics of the disease |
| topic | pseudomembranous colitis antibiotics clostridial infection probiotics antibiotic-associated diarrhea |
| url | https://ter-arkhiv.ru/0040-3660/article/viewFile/637236/pdf |
| work_keys_str_mv | AT konstantindermolenko predictionofthecourseofantibioticassociateddiarrheacausedbyiclostridioidesdifficileibasedonclinicalandlaboratorycharacteristicsofthedisease AT tatianavpotapova predictionofthecourseofantibioticassociateddiarrheacausedbyiclostridioidesdifficileibasedonclinicalandlaboratorycharacteristicsofthedisease AT kseniiavsilav predictionofthecourseofantibioticassociateddiarrheacausedbyiclostridioidesdifficileibasedonclinicalandlaboratorycharacteristicsofthedisease AT konstantinvzhdanov predictionofthecourseofantibioticassociateddiarrheacausedbyiclostridioidesdifficileibasedonclinicalandlaboratorycharacteristicsofthedisease AT dmitryalioznov predictionofthecourseofantibioticassociateddiarrheacausedbyiclostridioidesdifficileibasedonclinicalandlaboratorycharacteristicsofthedisease AT denisagusev predictionofthecourseofantibioticassociateddiarrheacausedbyiclostridioidesdifficileibasedonclinicalandlaboratorycharacteristicsofthedisease |